Frontiers in clinical diabetes and healthcare最新文献

{"title":"Navigating ambivalence: perspectives on healthy eating habits and readiness for change among Swedish men with prediabetes.","authors":"Åsa Carlsund, Åsa Hörnsten, Fatima Hoosen, Stephen Amoah, Julia Otten","doi":"10.3389/fcdhc.2026.1793053","DOIUrl":"10.3389/fcdhc.2026.1793053","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes accounts for over 90% of all diabetes cases and continues to rise globally, with projections reaching 853 million adults by 2050. Prediabetes, a key risk state, offers a critical window for prevention, as lifestyle changes can reduce progression to type 2 diabetes by nearly 50%. Despite clear guidelines emphasizing diet and physical activity, adherence remains challenging due to socioeconomic, cultural, and behavioral barriers.</p><p><strong>Aim: </strong>The aim of this study was to explore men's attitudes toward managing their diet and lifestyle after being diagnosed with prediabetes.</p><p><strong>Methods: </strong>A qualitative study used individual and group interviews with 21 Swedish men aged 60-72 with prediabetes, recruited from the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort via convenience sampling. Data collected from May to August 2025 through Microsoft Teams included open-ended questions. Interviews were audio-recorded and transcribed. Analysis followed Graneheim and Lundman's qualitative content analysis.</p><p><strong>Results: </strong>The men recognized the importance of healthy habits but doubted they could maintain lasting change. This ambivalence was caused by personal limitations and a focus on short-term goals. Some men sought support from family or friends, moving from contemplation to preparation. Learning from successes and setbacks, they gained a more realistic view of their ability to change. The analysis identified one main theme, \"Grasping the message about healthy habits but still doubting one's ability to change\", and two additional themes, each with three subthemes.</p><p><strong>Conclusion: </strong>Men with prediabetes know how to eat healthy but struggle to turn knowledge into habits. Emotional distress, ambivalence, and triggers often undermine motivation. Short-term goals like weight loss dominate over long-term strategies. Yet, men seek social support and engaging activities, showing readiness for change.</p><p><strong>Implications: </strong>Interventions should target psychological barriers, use social networks, and offer practical strategies for lasting lifestyle changes.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1793053"},"PeriodicalIF":3.5,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety evaluation of Sodium-glucose cotransporter 2 inhibitors for cancer risk in specific populations: systematic review and meta-analysis.","authors":"Jing Teng, Tai Li, Ying Tan, Huifang Tang","doi":"10.3389/fcdhc.2026.1775359","DOIUrl":"10.3389/fcdhc.2026.1775359","url":null,"abstract":"<p><strong>Aims: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors, commonly treated for Type 2 diabetes mellitus (T2DM), have demonstrated benefits in reducing cardiovascular and renal events. However, heart failure (HF) and chronic kidney disease (CKD) are prevalent comorbidities in T2DM. This study aims to assess the long-term safety of SGLT2 inhibitor, particularly concerning cancer risk in these populations.</p><p><strong>Methods: </strong>We searched PubMed, CENTRAL, Web of Science, and ClinicalTrials.gov for studies published up to April 16, 2024. The primary outcome was overall cancer risk, with secondary outcomes focused on specific cancer types. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated. This meta-analysis was registered in PROSPERO (CRD42024560310).</p><p><strong>Results: </strong>28 randomized controlled trials involving 98,297 participants were included. SGLT2 inhibitors did not increase overall cancer risk (RR = 1.05, 95% CI [0.99, 1.12]). Furthermore, the use of SGLT2 inhibitors does not exhibit a significant association with the risk of several common cancer types. Subgroup analyzes indicated that SGLT2 inhibitors appeared to be temporarily safe in patients with HF (RR = 1.03, 95% CI [0.91, 1.18]), CKD (RR = 1.02, 95% CI [0.90, 1.16]) and T2DM related comorbidities. Additionally, none of the different types of SGLT2 inhibitors increase the overall cancer risk.</p><p><strong>Conclusions: </strong>SGLT2 inhibitors do not appear to increase overall cancer risk, including several common cancers such as breast cancer and bladder cancer. The use of SGLT2 inhibitors in different patient populations is temporarily safe.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD42024560310.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1775359"},"PeriodicalIF":3.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living with what is lost: reframing emotional life with diabetes through an integrative perspective on loss and grief.","authors":"Bryan Cleal, Linxi Mytkolli, Kristoffer Bastrup-Madsen Marså, Mette Due-Christensen, Dan Grabowski, Jonathan Garfinkel, Carlo Leget, Mai-Britt Guldin","doi":"10.3389/fcdhc.2026.1771568","DOIUrl":"10.3389/fcdhc.2026.1771568","url":null,"abstract":"<p><p>Over the past three decades, the concept of diabetes distress has played a central role in legitimising the emotional burdens of living with diabetes without pathologising them. Diabetes distress has helped foreground the frustrations, worries, and exhaustion associated with the ongoing demands of self-management and interactions with healthcare systems, and it has provided an important counterweight to purely biomedical models of care. However, while clinically useful, diabetes distress primarily captures emotional responses linked to burden, effort, and perceived threat. It may not fully encompass the quieter, cumulative, and more existential dimensions of emotional life that unfold across the long course of living with diabetes. In this conceptual article, we introduce loss and grief as a complementary lens for understanding these aspects of experience. Drawing on the Integrative Process Model of Loss and Grief (IPM), originally developed within bereavement research, we explore how living with diabetes involves ongoing and often ambiguous losses that affect bodily trust, identity, social participation, imagined futures, and meaning. The IPM conceptualises grief as a dynamic, integrative process unfolding across five interrelated dimensions: physical, emotional, cognitive, social, and spiritual. Rather than treating grief as a time-limited response to a discrete event, the model emphasises adaptation to cumulative and enduring forms of loss, making it particularly relevant to chronic illness. We do not propose grief as an alternative to diabetes distress. Instead, we argue that distress and grief represent overlapping but distinct perspectives on the same lived reality. Diabetes distress foregrounds the pressures and emotional load of self-management, while a grief-informed perspective highlights processes of adaptation, meaning-making, and identity renegotiation over time. Placing these perspectives together allows for a more textured understanding of emotional life with diabetes, including experiences that may not register in screening tools or routine clinical encounters.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1771568"},"PeriodicalIF":3.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Platelet-rich plasma combined with multimodal therapy for diabetic foot ulcer with tophi: a case report.","authors":"Xinjie Duan, Xinjuan Sun, Yang Liu, Maoyuan Chen, Li Dong","doi":"10.3389/fcdhc.2026.1863254","DOIUrl":"https://doi.org/10.3389/fcdhc.2026.1863254","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fcdhc.2026.1795474.].</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1863254"},"PeriodicalIF":2.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology, diagnostics, treatments, and pregnancy outcomes of gestational diabetes mellitus in Africa: a systematic review, meta-analysis, and bibliometric study.","authors":"Benjamin Aye Simon, Yasmeen Thandar, Nalini Govender, Francis Akpa-Inyang, Lawrence Chauke","doi":"10.3389/fcdhc.2026.1795881","DOIUrl":"10.3389/fcdhc.2026.1795881","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is an increasingly important contributor to maternal and neonatal morbidity in Africa, yet the evidence base remains fragmented across settings and research domains. This study integrates systematic review and meta-analysis with bibliometric analysis to synthesize epidemiological evidence, characterize research activity, and examine risk factors, diagnostic practices, management strategies, and pregnancy outcomes related to GDM in Africa.</p><p><strong>Methods: </strong>Publications reporting on GDM in African populations were retrieved from major scholarly databases. Bibliometric techniques were applied to evaluate publication trends, collaboration networks, and thematic structures. In parallel, 241 studies from 33 countries were systematically reviewed. Study quality was assessed, demonstrating gradual improvement over time (Spearman's ρ = 0.307). A random-effects meta-analysis was conducted to estimate pooled GDM prevalence.</p><p><strong>Results: </strong>Research output increased steadily over time but remained concentrated in a limited number of countries, with minimal regional collaboration. Dominant research themes focused on metabolic risk, diagnostic testing, and pregnancy outcomes, while health-systems and implementation research were comparatively scarce. Across 44 prevalence studies, the pooled GDM prevalence was 12.62% (95% CI: 10.23%-15.21%) using a Freeman-Tukey-transformed and DerSimonian-Laird random-effects model. Heterogeneity was considerable (I² = 98.4%), with a wide 95% prediction interval (1.18%-33.50%), indicating substantial contextual variability. Prevalence estimates ranged from 0.7% to 45.9%. Common risk factors included advanced maternal age, elevated body mass index, family history of diabetes, and prior obstetric complications. Diagnostic and management approaches varied widely, with increasing adoption of the 75 g OGTT and IADPSG/WHO 2013 criteria.</p><p><strong>Conclusions: </strong>GDM prevalence in Africa is substantial and highly heterogeneous, reflecting uneven diagnostic practices and research capacity. Strengthened regional collaboration, greater harmonization screening, and improved health-system integration are essential to inform effective and contextually appropriate maternal health policies.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1795881"},"PeriodicalIF":3.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 5-C model of digital health accompaniment: empowering women through a gestational diabetes self-care intervention in Vietnam.","authors":"Tine M Gammeltoft, Thị Kim Dung Vũ, Ngọc-Anh Thị Đạng, Thị Minh Phương Nguyễn, Ái T Nguyễn, Ib C Bygbjerg","doi":"10.3389/fcdhc.2026.1738433","DOIUrl":"10.3389/fcdhc.2026.1738433","url":null,"abstract":"<p><strong>Background: </strong>Globally, gestational diabetes mellitus (GDM) is a growing health problem. When diagnosed with GDM, women often lack adequate health systems and social support, finding themselves alone at the frontier of epidemiological change. This ethnographic study investigated experiences of GDM and self-care practices among women in Vietnam, with a particular focus on the significance of an online intervention for women's self-care agency.</p><p><strong>Methods: </strong>Ethnographic data from in-depth interviews with 42 women with GDM living in the Red River delta of northern Vietnam were analyzed. The research was conducted in two phases. In the first phase, women with GDM received standard care, while women in the second phase participated in a digital pregnancy care intervention combining peer- and professional support. Ethnographic data from both phases were systematically coded, analyzed, and compared.</p><p><strong>Results: </strong>The study found that the intervention achieved its impact through <i>accompaniment</i>, supporting GDM self-care through presence and human connection. While women receiving standard care often found themselves in a stressful impasse between Internet-derived information emphasizing the dangers of GDM and family members urging them to ignore the condition, women involved in the digital intervention mobilized knowledge and support attained through the intervention to actively seek assistance from family members and carve out spaces for self-care. Women used the intervention to leverage family love. To capture the factors that made this intervention a source of accompaniment, we developed the 5-C model of digital health accompaniment, highlighting how <i>co-creation, combined knowledge, community spirit, continued presence</i>, and <i>commitment over time</i> facilitated health care accompaniment.</p><p><strong>Conclusions: </strong>For many women worldwide, pregnancy is an emotionally intense period marked by high stakes and anxious expectations. When GDM is diagnosed, uncertainties tend to intensify. In this context, our findings suggest that digital interventions can serve not merely as tools for health education or monitoring, but as infrastructures of accompaniment that strengthen women's self-care, while also enabling them to mobilize family members' attention and support. We argue that such accompaniment represents an important source of reproductive empowerment that warrants greater attention in research, policy, and practice, holding potential to contribute to health system strengthening.</p><p><strong>Clinical trial registration: </strong>https://anthropology.ku.dk/research/research-projects/current-projects/_living-together-with-chronic-disease-part-ii/, identifier NCT05744856.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1738433"},"PeriodicalIF":3.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum uric acid and the incidence of new-onset metabolic syndrome among military young adults in Taiwan: the CHIEF cohort study.","authors":"Wei-Che Huang, Yun-Chen Chang, Kun-Zhe Tsai, Chen-Ming Huang, Han-Hsing Chen, Hui-Shan Wang, Gen-Min Lin","doi":"10.3389/fcdhc.2026.1822830","DOIUrl":"10.3389/fcdhc.2026.1822830","url":null,"abstract":"<p><strong>Backgrounds: </strong>Serum uric acid (SUA), a purine metabolite, can reflect the status of low-grade inflammation in the body, which may contribute to metabolic syndrome (MetS). However, the association has been found to be weak in men, especially in elderly individuals. Whether this association is present in young men remains unclear. This study aimed to investigate the association between SUA concentrations and the incident MetS among military personnel, most of whom were young men.</p><p><strong>Materials and methods: </strong>This cohort study included 2,890 Taiwanese military personnel (90% male), aged 18-39 years, who were free of MetS at baseline following new-onset MetS from 2014 (baseline) through the end of 2020. SUA concentrations were measured at baseline. Incident MetS was diagnosed using the modified NCEP ATP III criteria and was identified during the annual military health examinations. A multivariable Cox regression analysis model adjusted for baseline age, sex, substance use, physical activity level, body mass index, blood urea nitrogen level, serum creatinine level, total white blood cell count and hemoglobin level was used to determine the association. Subgroup analyses were performed for each component of MetS.</p><p><strong>Results: </strong>During a mean follow-up of 6.0 years, 673 incident MetS events (23.3%) were reported. Higher SUA concentrations (every 1 mg/dL increase) were associated with a greater risk of MetS [hazard ratio: 1.22 (95% confidence interval: 1.15-1.30)]. There were no significant differences within each MetS component, i.e., central obesity, hypertension, hyperglycemia or dyslipidemia, according to the subgroup analyses.</p><p><strong>Conclusion: </strong>This study suggests that higher SUA concentrations are associated with a greater risk of new-onset MetS among Taiwanese military personnel, most of whom were young men, and the association was consistent across the MetS subgroups. Since this prospective cohort study is observational, the cause-and- effect association requires further investigation.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1822830"},"PeriodicalIF":3.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening practices, diabetic retinopathy knowledge, and conflict-related barriers to healthcare access among adults with diabetes in Palestine: a cross-sectional study.","authors":"Alhareth M Amro, Anas K Assi, Rama F Rejee, Salahaldeen Deeb, Lama Amro, Zein Abuhantash, Amr Abu Hadwan, Raghad Neiroukh, Shatha Arman, Aya Abufelat, Fatma Qadi, Lamar Aabed, Afnan Manasrah, Abeer Khaleel Srour, Hani Rjoob","doi":"10.3389/fcdhc.2026.1814878","DOIUrl":"10.3389/fcdhc.2026.1814878","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) is a major preventable cause of vision loss. This study assessed DR-related knowledge and screening practices among adults with diabetes in Palestine and explored conflict-related barriers to healthcare access.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from June to December 2025 using an Arabic questionnaire distributed in ophthalmic clinics and online. Knowledge was assessed as a continuous score (0-14) and analyzed using multiple linear regression analyses. Comprehensive screening practice was strictly defined as receiving a dilated fundus examination in the preceding 12 months. Multivariable models identified the independent factors associated with knowledge and comprehensive screening.</p><p><strong>Results: </strong>A total of 740 participants were included (mean age 55.6 years; 59.9% female; 84.2% type 2 diabetes). The mean knowledge score was 10.65/14. Although general awareness was high, disease-specific knowledge and treatment awareness were limited. Multiple linear regression analyses (Adjusted R² = 0.432) demonstrated that higher education, urban residence, and higher income were significantly associated with higher knowledge scores. Notably, reporting conflict-related healthcare disruptions was independently associated with a 1.02-point increase in knowledge (p < 0.001). While 75.0% reported any eye examination in the last year, only 30.7% reported receiving a comprehensive dilated fundus examination. The most common reason for not being examined in the last year was perceiving screening as unnecessary. Conflict-related reduced healthcare access was reported by 67.4%. In multivariable logistic regression analyses, urban residence and a history of eye disease were strong independent correlates of comprehensive screening adherence, whereas the conflict was not significantly associated (p = 0.681).</p><p><strong>Conclusions: </strong>Despite high general awareness, gaps persist in DR-specific knowledge and in receipt of comprehensive retinal screening. Targeted education, standardized referral pathways, and accessible screening models are needed, particularly for rural and socioeconomically disadvantaged groups where structural and geographic barriers appear to outweigh the acute impact of healthcare disruptions on screening adherence.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1814878"},"PeriodicalIF":3.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of canagliflozin on kidney resistive index and oxygenation in patients with type 2 diabetes: findings obtained with ultrasonography and blood oxygenation level-dependent MRI.","authors":"Hideki Uedono, Katsuhito Mori, Tsutomu Inoue, Yuri Machiba, Fumiyuki Morioka, Shinya Nakatani, Akihiro Tsuda, Hirokazu Okada, Masanori Emoto","doi":"10.3389/fcdhc.2026.1733806","DOIUrl":"10.3389/fcdhc.2026.1733806","url":null,"abstract":"<p><strong>Background: </strong>Details regarding kidney-protective mechanisms of sodium-glucose cotransporter 2 (SGLT2) inhibitors remain unclear. High kidney resistive index (RI), evaluated by Doppler ultrasonography, and low T₂* value, evaluated by blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) are risk factors for chronic kidney disease progression. In our previous study, canagliflozin (Cana) improved kidney oxygenation. In this <i>post-hoc</i> analysis, the effects of Cana on RI, as well as the correlation between changes in RI and T₂* values, were evaluated.</p><p><strong>Methods: </strong>Thirteen patients with type 2 diabetes (T2D) were analyzed. RI was determined at screening and on Day 5 (D5) following administration of Cana, while BOLD MRI was performed on D0, D1 (administration day), and D5. Cortical T₂* values were evaluated using twelve-layer concentric object (TLCO) and region of interest (ROI) methods. Changes in RI and T₂* values from D0 to D1 or D5 are expressed as ΔRI, ΔT₂* (D1-D0), and Δ T₂* (D5-D0), respectively.</p><p><strong>Results: </strong>Cana significantly decreased RI, while ROI findings showed increased T₂* (D0: 54.5 [50.8-55.5] vs D1: 56.2 [52.7-56.4], <i>p</i> = 0.003, <i>r</i> = 0.77; D0 vs D5: 54.5 [53.0-57.2], <i>p</i> = 0.080, <i>r</i> = 0.49). A significant negative correlation between ΔRI and ΔT₂* (D1-D0) was shown by both TLCO (<i>ρ</i> = -0.621, <i>p</i> = 0.024) and ROI (<i>ρ</i> = -0.557, <i>p</i> = 0.048).</p><p><strong>Conclusion: </strong>Short-term Cana treatment improved RI and kidney oxygenation in patients with T2D. The inverse correlation found between changes in RI and T₂* values suggest a mechanistic link between hemodynamic changes and improved oxygenation by SGLT2 inhibitors.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1733806"},"PeriodicalIF":3.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular pathways, tissue-specific roles, and therapeutic opportunities in mitochondrial resilience-based strategies for insulin resistance.","authors":"Yousef M Almoghrabi, Basmah M Eldakhakhny, Ghada Ajabnoor, Faisal Alandejani, Ahmad Jamal, Dareen Alyousfi, Ahmad M Alzahrani, Mostafa A Elsamanoudy, Taghreed Shamrani, Ayman Z Elsamanoudy","doi":"10.3389/fcdhc.2026.1790182","DOIUrl":"10.3389/fcdhc.2026.1790182","url":null,"abstract":"<p><p>Insulin resistance (IR) is characterized by impaired insulin signaling in skeletal muscle, liver, and adipose tissue. Increasing evidence indicates mitochondrial dysfunction as a key factor contributing to IR. Mitochondrial resilience refers to the mitochondria's ability to adapt to metabolic stress by regulating biogenesis, dynamics, mitophagy, and redox homeostasis. Linking mitochondrial resilience with insulin signaling could be essential for maintaining metabolic health. This review aims to map and synthesize the existing literature on the relationship between mitochondrial resilience and insulin resistance, focusing on cellular and molecular mechanisms, tissue-specific roles, metabolic consequences, and translational evidence from both animal and human studies. This scoping review adhered to PRISMA-ScR guidelines and included comprehensive searches of PubMed, Scopus, Web of Science, Embase, and Google Scholar. It included experimental and observational studies, original articles, systematic reviews, and meta-analyses, while excluding non-English publications and animal studies without clinical relevance. A total of 7, 012 records were identified; after removing duplicates, screening, and assessing eligibility, 184 studies were included. The evidence shows that impaired mitochondrial biogenesis, defective mitochondrial dynamics, reduced mitophagy, and oxidative stress disturb insulin signaling and promote metabolic inflexibility. Conversely, enhancing mitochondrial resilience increases mitochondrial quantity and function. Lifestyle modification strategies and pharmacological intervention target these pathways to improve mitochondrial resilience. Importantly, understanding inter-individual differences in mitochondrial adaptive capacity may support the development of personalized therapeutic and nutritional strategies aimed at improving insulin sensitivity and metabolic outcomes. In conclusion, mitochondrial resilience provides a comprehensive framework connecting mitochondrial quality to insulin signaling and metabolic health. Focusing on mitochondrial resilience is a promising, mechanism-based strategy for preventing and managing insulin resistance and its related comorbidities.</p>","PeriodicalId":73075,"journal":{"name":"Frontiers in clinical diabetes and healthcare","volume":"7 ","pages":"1790182"},"PeriodicalIF":3.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}